Writing with Scissors is the blog site of Howard Rodenberg, MD MPH, former Kansas State Health Director and columnist for the Journal of Emergency Medical Services (JEMS). He is a father, emergency physician, and slightly-past-fifty curmudgeon with great hair for his age. The "scissors" in question refer to those used by editors to weed out all things opinonated, controversial, or politically inappropriate...translated as "anything funny."

a new day
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2016 is literally around the corner, leaving me with 18 months to
retirement. Its with a mixture of trepidation, expectation and hope that I
turn the page....

1 year ago

Sunday, January 10, 2010

Name Calling

We all learned in grade school about homonyms They’re the words that sound the same with but have different spellings (like “bear” and “bare”), or that are spelled the same with different meanings (“bear,” as to carry, or “bear,” as to Yogi). But I’m always surprised at how useful certain homonyms can be.

Billy Ray was brought into the ED by EMS after riding his bicycle into a moving car. That much we knew from the paramedics. To ask Billy Ray, however, it turned out that he had a (present participle describing an Oedipal relationship) fall at some undefined (term alluding to said Oedipal relationships) place and that the (continuing maternal carnal experience) paramedics delivered him against his will to this (persistent use of similar euphemism) place. Professional that I am, I continued with my exam, braving the torrent of commentary ranging from other relationships I might have with members of my own gender to comments regarding bodily excretions as well as thoughts regarding the legitimacy of my parentage.

(For those of us who grew up on Schoolhouse Rock, you could make the case that Billy Ray’s use of the aforementioned term does not really represent a homonym, but has simply unpacked a single a multipurpose adjective meaning “generally unpleasant.” I prefer the homonym explanation, as one senses that he says it with different intent, and additional virulence, at some moments than others. But I digress.)

I told Billy Ray that he needed to stay in the exam area, keep on his neck collar, and we’d get X-rays of the things that hurt. I also asked him to simmer down so as not to be a distraction to other patients in the ED. His reply demonstrated his unique insight into the process of medical decision-making.

“So if got a (reference to a disagreeable situation) bump on my (impolite descriptor originating in World War II), you’d get a (expression of displeasure) X-ray of that?”

“Yep, we probably would.”

“Ahhh, you’re all a bunch of (group of individuals participating in aforementioned relations). Pointing at us individually in turn, he shouted “You’re a (rhyme with other ducker ). And you’re a (repeated phrase). And you, Doctor (sound-alike for jelly maven Mother Smucker), what’s your (adjective form of the nominative term) name again?

I had earlier introduced my self by my real name, but I figured that part of my job was to try to establish a true rapport with my transient acquaintance. One thing I had learned over the years is that with an acutely agitated patient, you don’t get control of the situation by re-orienting them to reality, but by going along with them as an ally. Social scientists would say that it was incumbent upon me to enter his world and build a bond of trust by which we could positively impact his health. So my response was, if not within the bounds of good taste, at least eminently logical.

“That’s one thing you got right. My name is Dr. (sound consonant with brother plucker), and if you don’t get your (previously mentioned incestuous adjective) (euphemism for donkey) back on the bed I’ll have (repeated prior adjective) Security tie you down. Got it?”

His eye widened, and then his face broke into a smile. “Okay,” he said, and sat down on the bed. And once again there was peace in the valley.

(The nurse caring for the patient shared a similar story later in the day. Once she had been called a “Cracker Whore” by a patient, and her reply was, “I’m from Maine. You can call me an Oyster Whore, or a Down-Easter Whore, but I’m not a Cracker.” My favorite one-liner was from several years ago, when another intoxicated member of society addressed a nurse as a (person who has foul carnal relations) and she retorted, “I may be a (repeated description), but I’m sure as hell not (performing an act) you.)

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Speaking of ED names, I’ve been called a lot of things over the years. (Some f them are even repeatable in mixed company). My first ED name was “Doogie,” because I become an attending physician about the same time that the “DoogieHowser, MD” show came on the air, and there was some vague resemblance between the youngish me and the even younger Neil Patrick Harris. That moniker lasted about six years, throughout my entire tenure at the University of Florida. There are still people at that institution, and throughout the prehospital care community in Florida, who have no idea that I have an actual name.

Following my Doogie phase there were two other names that were more or less interchangeable. Both depended on the fact that I was tall and skinny with essentially a bowel haircut. Which one applied depended on if I had shaved that morning. If I had, it was “Gilligan.” If not, it was “Shaggy.” (To this day, I often say “Zoinks!” for no apparent reason.

More recently, I have become the “RODHO.” The RODHO (pronounced “Road-hoe”) comes from our computer system here at the hospital where I work, which codes physician names as the first three letters of your last name followed by the first two letters of your first name. If your name is Jawed Panja (one of the hospitalists who works in our facility), the computer thinks you name is, appropriately enough, PANJA. If you’re me, you become the RODHO. If you’re one of my ED colleagues, Dr. Matthew Kocisko, you become the KOCMA, which is even funnier.We’ve had a lot of fun with the RODHO. The RODHO has an Official Motto (“I serve all who solicit my services at discount prices.”) The RODHO is easily adaptable to poetry and music. For example, with apologies to Lewis Carroll:

The time has come, the RODHO said,To speak of many things.Of pain and fractured fibulaeWhich law enforcement brings

Or maybe a Beatles reference:

You have the back pain.You want the Lortab.I am the RODHO!Goo goo gaju.

Or, if you just want to rock out to The Kinks:

RO-AD HO!RO-RO-RO-RO-ROAD HO!RO-RO-RO-RO-ROAAAADD HO!”

(Okay, maybe that last one is better sung. With beer. Lots of beer.)

About two months ago, I got another nickname. I was walking out of the ED about midnight as an ambulance was unloading a patient out the back. The patient saw me, we locked eyes for the briefest moment, and I waved politely. He suddenly reared up on the stretcher and yelled “HEY!”

“Yeah, what’s up?” I’m a friendly guy.

“You look like somebody on TV!”

I’d heard this one before. “Gilligan, right? Shaggy from Scooby-doo?”

“No, man. You look like McDreamy!”

So now I’m also McDreamy. My colleague Keven MacMahon, never one to be left out, has become McSteamy. Three days ago McDreamy and McSteamy were talking to Dr. J.D. Henson, who mentioned that he felt left out without a nickname as well. After momentary consideration, we thought he kind of looked like someone we had all grown up with on PBS, older mustached gentleman with a kind way about him as he made his perpetual postal rounds.